The whole thing was a stupid idea by a right-wing thinktank. It tries to help by establishing a cap on profits and spreading the costs around by requiring everyone to be insured, but it depended on states increasing their Medicaid eligibility, which red states did not. It did nothing to actually decrease the cost of care.
I consider it a mess, not a complete failure. The problem is that we only have one candidate who's serious about fixing the situation, and it's unlikely he's going to get his party's nomination. His competitor thinks this system is wonderful and defends it. On the other side, one guy wants to repeal it altogether and just screw over anyone who can't afford insurance, and with the other guy no one really knows what he's going to do because he keeps changing his position, though he did say something in favor of universal healthcare a while back, but his current website has switched to some standard lame Republican ideas about letting insurance companies compete over state lines, so they'll all just move to the least-regulated state like Wyoming.